Structural changes in brain regions involved in executive-control and self-referential processing after sleeve gastrectomy in obese patients
Obesity-related brain gray (GM) and white matter (WM) abnormalities have been reported in regions associated with food-intake control and cognitive-emotional regulation. Bariatric surgery (BS) is the most effective way to treat obesity and induce structural recovery of GM/WM density and WM integrity. It is unknown whether the surgery can promote structural changes in cortical morphometry along with weight-loss. Structural Magnetic Resonance Imaging and surface-based morphometry analysis were used to investigate BS-induced alterations of cortical morphometry in 22 obese participants who were tested before and one month post-BS, and in 21 obese controls (Ctr) without surgery who were tested twice (Baseline and One-month). Results showed that fasting plasma ghrelin, insulin, and leptin levels were significantly reduced post-BS (P < 0.001). Post-BS there were significant decreases in cortical thickness in the precuneus (PFDR < 0.05) that were associated with decreases in BMI. There were also significant increases post-BS in cortical thickness in middle (MFG) and superior (SFG) frontal gyri, superior temporal gyrus (STG), insula and ventral anterior cingulate cortex (vACC); and in cortical volume in left postcentral gyrus (PostCen) and vACC (PFDR < 0.05). Post-BS changes in SFG were associated with decreases in BMI. These findings suggest that structural changes in brain regions implicated in executive control and self-referential processing are associated with BS-induced weight-loss.
KeywordsObesity Bariatric surgery Cortical morphometry Linear mixed effects
This work is supported by the National Natural Science Foundation of China under Grant Nos. 61431013, 81470816, 81501543, 81601563, and 81730016; National Clinical Research Center for Digestive Diseases, Xi’an, China under Grant No. 2015BAI13B07; and support in part from the Intramural Research Program of the United States National Institute on Alcoholism and Alcohol Abuse, Z01AA3009 (ESK, DT, NDV, GJW). We thank Mingzhu Xu and Long Qian for their contribution to the manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare no conflict of interest.
Informed consent was obtained from all patients included in the study.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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